What’s coming in health IT in 2016

WHAT TO EXPECT IN 2016: November’s elections are roughly 10 months away, but their effect is already being felt in the health IT world. Expectations for congressional and regulatory accomplishment have been trimmed, given the fact that Congress will spend a mere four weeks in Washington between mid-July and mid-November. That leaves little time to finish up legislative work before campaign season goes full tilt. And team Obama won't be launching big health IT initiatives as its calendar counts down. Here’s a rundown of what to look for this year. Pros can access the full story here: http://politico.pro/1VAYz6P

21st Century Cures Action: The Senate probably has until about Memorial Day to pass its companion to the House's bill. That would leave barely enough time to reconcile any differences with the House version. While Senate HELP Committee Chairman Lamar Alexander has said the medical innovation bill will be his top priority this year, the window is narrow, given that several self-imposed deadlines were missed in 2015.

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Meaningful use: Complaints about the EHR incentive program are sure to continue in 2016, but policy experts don’t expect that to translate into changes. With the Obama White House on the way out and a Congress that was been unwilling to force CMS’s hand, the status quo of Stage 2 is expected to continue.

All eyes on MACRA: CMS will be working on implementing the April 2015 law, in part by building out the Merit-based Incentive Payment System. A proposed rule that folds the meaningful use program into the new MIPS system is expected this spring or early summer.

Telemedicine: Lobbyists fighting to expand Medicare technology payments have a good chance of get something enacted through the Senate Finance Committee’s chronic care working group. It will be tough to finish on an abbreviated congressional calendar, but senators have been fleshing out telemedicine policy proposals in their work. Meanwhile, Medicare’s Next Generation ACOs will be free to use the technology as they see fit, and CMS will continue telemedicine experiments through its innovation center.

ONC: Chief Karen DeSalvo dropped a bomb when she said last month ONC wanted to connect all health information exchanges by the end of this year. That's an ambitious target, obviously.

Mental health: Reform in this are will receive a great deal of attention by Congress, especially as regards the handling of patients’ substance abuse records and other privacy issues.

DoD implementation: The Defense Department is expected to roll out its new EHR system in initial Pacific Northwest sites later this year.

Cybersecurity: HHS will be busy implementing the Cybersecurity Act of 2015, which mandates an HHS report on cybersecurity, directs the department to create a framework of health care-specific security best practices and standards, and creates a task force to study the best way to share cyberthreats within the health care world.

FORTHCOMING FDA GUIDANCE: The FDA’s device center is out with the list of guidance documents it intends to publish in the coming year. Making the cut is draft guidance on using patient-generated data in medical device decision making. Falling under the heading “we’ll get to it if we can” are draft guidance on device interoperability and patient access to information. The full list: http://1.usa.gov/1MMyVou

WORTH A READ: ProPublica’s Charlie Ornstein took a close look at HIPAA complaints received by HHS’s Office for Civil Rights and how they have translated into enforcement actions. Turns out, OCR “only rarely imposed sanctions for small-scale privacy breaches that caused lasting harm,” Ornstein reports. “The patterns you’ve identified makes a person wonder how far a company has to go before HHS recognizes a pattern of noncompliance,” says Joy Pritts, ONC’s former chief privacy office. Find the story here: http://bit.ly/1kqpi8j

WHILE WE WERE AWAY: The Pro eHealth team didn’t stop producing features over our holiday break. Here’s a summary of what we published since our last Morning eHealth:

FIRST IN MORNING EHEALTH: The growth of connected health — the use of remote monitoring, wearable sensors and apps — will be “substantial and swift” as more studies emerge demonstrating its role in improved health outcomes, ACT | The App Association says in its State of the App Economy report out this morning. Top opportunities in the field are chronic disease management, personal fitness and remote monitoring, a market expected to be $46 billion by next year. http://bit.ly/1UmdpMZ

TAKE MY CODES, PLEASE: The American Telemedicine Association is out with a request of 36 telemedicine billing codes it wants Medicare to start paying for in 2017. These are existing in-person services that the association thinks should also be covered when delivered via telemedicine. If accepted, the new code conditions would be listed in the physician fee schedule sometime this summer. The codes would still be subject to Medicare’s severely restrictive telemedicine requirements, like those that require the patient to be in a rural health care facility. The document: http://politico.pro/1mq297V

DELAWARE TELEMEDICINE NEWS: The ERISA Industry Committee generally likes the Delaware insurance commission’s proposed telemedicine regulations. But in comments submitted last week, the group takes issue with a requirement that payers offer the same rate for in-person and telemedicine visits, saying it “imposes an unnecessary and inflexible mandate on payers. ... If cost-savings are achieved through telehealth," the group says, " those savings should be reflected in the cost and reimbursement rates of telehealth services.” The full letter: http://bit.ly/22DwUXv

NEW FROM ONC: Over the holidays the office released an online summary of policy levers states can use to advance health IT and interoperability. Among the 32 levers are Medicaid state plan amendments, accountable care arrangements and insurance policies. The full compendium: http://bit.ly/1PFFOOX

UNCLE SAM WANTS TO HEAR FROM YOU: ONC and CMS have issued a request for information on how to better incorporate quality reporting requirements into EHR certification. “CMS and ONC request feedback on how often to require recertification, the number of clinical quality measures to which a certified Health IT Module should be certified, and ways to improve testing of certified Health IT Module(s),” CMS officials wrote in a blog post.

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About The Author

David Pittman is an eHealth reporter for POLITICO Pro.

Before joining POLITICO in May 2014, Pittman served as the lone Washington reporter for the health news website MedPage Today, covering nearly all aspects of health policy from Medicare and Medicaid to the Affordable Care Act and Capitol Hill. He has also covered science and regulatory policy for trade newsletter company FDAnews and the weekly newsmagazine Chemical & Engineering News. Pittman got his start in journalism covering healthcare for the daily newspaper in the West Texas town of Amarillo.

Pittman holds bachelor's degrees in journalism and chemistry from the University of Georgia, where he graduated in 2006. While in Athens, Pittman worked as a staff writer of The Red & Black and eventually became editor-in-chief, pestering school administrators. Like any good Southerner, he prefers his tea sweet, chicken fried and fall Saturdays reserved for college football. He is also surviving as an Atlanta Braves fan in a town full of Washington Nationals supporters.